Immunologic aspects of dermal and oral lichen planus: a review

There have been many investigations, both experimental and epidemiologic, of the forms of LP affecting the skin and oral mucosae. These studies have provided a varied range of hypotheses to explain not only the factors determining susceptibility to and onset of this disease, but also the immunologic mechanisms leading to the pathosis with which LP is associated. Much progress has been made, especially through in vitro studies, regarding detailed aspects of the immunology of LP. However, data is often conflicting or incomplete. In this review we attempt to bring together the currently available data regarding the immunologic basis of LP.

Characterization of the MODY3 phenotype. Early-onset diabetes caused by an insulin secretion defect

Maturity-onset diabetes of the young (MODY) type 3 is a dominantly inherited form of diabetes, which is often misdiagnosed as non-insulin-dependent diabetes mellitus (NIDDM) or insulin-dependent diabetes mellitus (IDDM). Phenotypic analysis of members from four large Finnish MODY3 kindreds (linked to chromosome 12q with a maximum lod score of 15) revealed a severe impairment in insulin secretion, which was present also in those normoglycemic family members who had inherited the MODY3 gene. In contrast to patients with NIDDM, MODY3 patients did not show any features of the insulin resistance syndrome. They could be discriminated from patients with IDDM by lack of glutamic acid decarboxylase antibodies (GAD-Ab). Taken together with our recent findings of linkage between this region on chromosome 12 and an insulin-deficient form of NIDDM (NIDDM2), the data suggest that mutations at the MODY3/NIDDM2 gene(s) result in a reduced insulin secretory response, that subsequently progresses to diabetes and underlines the importance of subphenotypic classification in studies of diabetes.

Mapping of a gene for type 2 diabetes associated with an insulin secretion defect by a genome scan in Finnish families

Non-insulin dependent diabetes mellitus (NIDDM) affects more than 100 million people worldwide and is associated with severe metabolic defects, including peripheral insulin resistance, elevated hepatic glucose production, and inappropriate insulin secretion. Family studies point to a major genetic component, but specific susceptibility genes have not yet been identified-except for rare early-onset forms with monogenic or mitochondrial inheritance. We have screened over 4,000 individuals from a population isolate in western Finland, identified 26 families (comprising 217 individuals) enriched for NIDDM and performed a genome-wide scan using non-parametric linkage analysis. We found no significant evidence for linkage when the families were analysed together, but strong evidence for linkage when families were classified according to mean insulin levels in affecteds (in oral glucose tolerance tests). Specifically, families with the lowest insulin levels showed linkage (P = 2 x 10(-6)) to chromosome 12 near D12S1349. Interestingly, this region contains the gene causing the rare, dominant, early-onset form of diabetes MODY3. Unlike MODY3 families, the Finnish families with low insulin have an age-of-onset typical for NIDDM (mean = 58 years). We infer the existence of a gene NIDDM2 causing NIDDM associated with low insulin secretion, and suggest that NIDDM2 and MODY3 may represent different alleles of the same gene.

The evolving nature of perinatal nursing

Current and future health-care trends create many challenges for perinatal nurses. A new mind set is required for the profession not only to accommodate the paradigm shift but provide leadership in designing a new future for health care. Interestingly, it has been predicted that the movement toward achieving healthier communities will result in a decentralized, community-based, nonhierarchical system that will not be male dominated. Nurses will be called on to participate in the development and implementation of health-care programs rather than assume a passive, recipient role. On the brink of the 21st century, nursing is in a position to emerge as a leader in providing cost-effective, needs-based, health-care services aimed at improving the health status of a community.

Perinatal nurse practitioners and health care reform

Health care delivery for pregnant women at high risk is changing in response to the nation's need to contain costs and improve care. Perinatal nurse practitioners can provide specialized care to women at high risk in a wide variety of settings. They provide quality, cost-effective care and can improve access to prenatal care for families at risk for untoward pregnancy outcomes.

Establishing a community health focus in perinatal nursing practice within a capitated environment

In this article, a model of care delivery is proposed that establishes a framework for meeting the health care needs of urban-dwelling women and children by organizing nursing care providers in a variety of delivery systems to balance access, quality, and cost. The program, intended as a component of an integrated health care network, illustrates the potential for nursing to assume a dominant role in providing health care services to a high-risk, high-cost population within a capitated environment.

The perinatal evaluation center: a nurse practitioner service delivery model

Efforts to reduce overall health care costs, improve efficiency and enhance patient and provider satisfaction have stimulated the design and evaluation of new models of practice. The Perinatal Evaluation Center, a nurse practitioner-staffed service providing triage and evaluation for obstetrical patients, was developed to address the competing demands of health care redesign. The service has yielded improved outcomes in measures of efficiency and satisfaction.

Serum antibody response to surface-associated material from periodontopathogenic bacteria

Saline extracts of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Eikenella corrodens contain surface-associated components of these bacteria. It has been shown that these extracts are potent stimulators of bone resorption in vitro. The possibility that the components of these surface-associated materials (SAM) could contribute to the serum immune response in patients with juvenile or adult onset forms of rapidly progressive periodontitis were investigated by direct binding ELISA. Very high titres of serum IgG antibodies to SAM from A. actinomycetemcomitans were detected in patients with localized juvenile periodontitis (LJP). Patients with adult onset rapidly progressive periodontitis (RPP) had significantly raised antibody levels to SAM from P. gingivalis. Both groups of patients had significantly raised levels of antibodies to SAM from E. corrodens compared with control sera. Thus, not only does solubilized SAM have the capacity to induce bone resorption, but it also contributes to the antigenic load on the immune system in LJP and RPP.

Effects of cereal grains on fibre digestion in vitro

Cereal grains including wheat, barley, oats, maize and sorghum were incubated with strained rumen fluid in vitro with either ryegrass or lucerne in the ratios of 0:100, 25:75, 50:50, 75:25 and 100:0 at 3g�C for 24 h. Expected NDF digestibilities in mixtures of cereal grain and forage were calculated by interpolation between NDF digestibilities of each grain and of each forage. These were compared with measured NDF digestibilities to detect deviations due to synergism or inhibition. Wheat, barley and maize had inhibitory effects, whereas oats and sorghum had synergistic effects, on NDF digestibility with both forages.

Microbial fermentation of cereal grains in vitro

The stoichiometry of fermentation was investigated in vitro with wheat and maize grains. Gas production proved to be an accurate index of VFA production and change in pH. Gas and total VFA production from wheat were strongly correlated with starch disappearance. On a stoichiometric basis, 66% of gas and 64% of VFAs produced from wheat were accounted for by starch fermentation. With maize only 18% of gas and 23% of VFAs produced were accounted for by starch disappearance. There were significant differences between grain species in rates of gas production (P < 0.001), being ranked in the order wheat > triticale, oats > barley > maize > rice, sorghum. Effects of varieties and growing sites on gas production were significant with wheat, oats, maize and sorghum. With barley, only varietal effects were significant (P < 0.001). With maize and sorghum, there were significant variety by site interactions.

Antibodies to mycobacterial stress protein in patients with orofacial granulomatosis

Immunoglobulin G antibody titers to the mycobacterial stress protein with molecular weight of 65 kDa (mSP65) were determined by ELISA in sera from 10 patients with orofacial granulomatosis (OFG). Four patients with confirmed Crohn's disease had serum antibodies to mSP65 with titers ranging from 400-950. Of six remaining patients, three patients had serum antibodies to mSP65, with titers ranging from 180-850, whilst no serum antibody to this antigen could be detected in 3 patients. However, other laboratory investigations failed to show any consistent pattern of disturbance in the 10 tested. Thus, the presence of serum antibody to mycobacterial 65 kDa stress protein might prove to be of a diagnostic value for Crohn's disease.

The reproductive performance of farmed fallow deer (Dama dama) in New South Wales

Observations on the reproductive performance of fallow deer on 47 farms in New South Wales were made over 6 consecutive years. The minimum fawning rate for does varied significantly (p less than 0.001) between years, the corresponding fawning percentages varying from 75.0% to 96.4%, with an overall mean of 88.8%. The weaning rate also varied significantly (p less than 0.001) between years, the corresponding percentages varying from 65.0% to 89.1% with a mean over 6 years of 81.4%. Weaning rates were low given the known high fertility of fallow deer. The ratio of male to female fawns at weaning varied significantly (p less than 0.05) between years, although the ratio was exactly 1:1 for all births recorded over the 6-year period. The mean birthweights for female and male fawns were 4.01 kg +/- 0.61 (n = 330) and 4.23 kg +/- 0.72 (n = 348) respectively. Mean birthweights varied significantly (p less than 0.001) between the sexes and between years. There was a greater difference between birthweights of male and female fawns in years with higher mean fawn birthweight. Fawn birthweights generally approximated 10% of the pre-rut weight of their mother. Handling of newborn fawns for tagging and weighting did not increase the chance of mismothering and rejection. The mean weaning weight for doe fawns and buck fawns over 6 years was 18.7 kg (n = 227) and 21.2 kg (n = 231) respectively, with a mean birth to weaning interval of 108.4 +/- 4.89 (n = 458). Growth rates of male fawns from birth to weaning were significantly higher (p less than 0.01) than for female fawns, and the growth rates of fawns were significantly different (p less than 0.01) between years.(ABSTRACT TRUNCATED AT 250 WORDS)

Dose dependent morphine-induced pupillary fluctuations in the rat: frequency analysis

Pupillary fluctuation induced by s.c. injection of morphine sulfate was studied in the rat using an infrared video pupillometer. The frequency and amplitude of the induced fluctuations throughout 47 min after drug injection was quantified using fourier analysis. Pupil fluctuation frequency was for the most part less than 0.25 Hz. The frequency profile showed a systematic increase in fluctuation amplitude with decreasing frequency. Aside from this systematic increase, no other consistent frequency trend was observed. The maximum drug effect occurred at approximately 15 min postinjection and remained constant for the remaining 30 min of the experiment. When fluctuation amplitude for all frequencies was pooled, a statistically significant, dose-dependent increase in fluctuation was found, with a peak effect between 10 and 40 mg/kg. Using frequency analysis techniques, we have demonstrated that pupil fluctuation induced by s.c. morphine administration in the rat is, like the concomitant mydriasis, a dose-related phenomenon.

Differentiating opioids by their pupillary effects in the rat

Pupillary effects of several opioids were examined as part of a broader in vivo study of multiple opioid receptors in the rat. Agonist activity, stereospecificity, and naloxone sensitivity were determined by methadone (Me), ethylketocyclazocine (EK), and N-allylnormetazocine (SKF 10,047), selected for their purportedly predominant actions at mu, kappa, and sigma receptors, respectively. After an acute, subcutaneous injection of each drug, pupil area and fluctuations in pupil size were measured by means of an infrared video pupillometer on line with a microcomputer data processing and storage system. Despite differences in the magnitude of the response, each opioid tested produced an increase in pupil size which was stereospecific, independent of behavioral responses to the drugs and, for 1-Me and 1-SKF 10,047, dose-related. Other differences among the opioids were found in their ability to induce fluctuations (1-Me and 1-EK) and a pendular nystagmus (1-SKF 10,047 only), and in their sensitivity to naloxone. Although 1.0 mg/kg naloxone completely reversed 1-Me-induced mydriasis, 10 mg/kg was needed to reverse 1-EK, and this dose only partially antagonized 1-SKF 10,047. These characteristic patterns of pupillary responses to opioids in terms of agonist activities and naloxone sensitivities indicate that the different opioid receptor types subserve different functions with respect to pupillary control.

Nutrient intakes of female adolescents from eight southern states

Nutrient intakes were calculated from two 24-hour recalls for 1,247 adolescent black and white girls. Whites consumed more vitamins E, C, and B-12, niacin, folacin, calcium, phosphorus, magnesium, and zinc and had higher intakes per 1,000 kcal of those nutrients, protein, vitamin D, and iron than blacks. Intakes of calcium (whites) and magnesium (both races) decreased with age. Urban girls consumed more energy and magnesium than rural ones. Folacin intake increased with income. Folacin intakes were most frequently below 67% RDAs, followed by intakes of iodine, vitamin D, iron, calcium, vitamin B-6, zinc, magnesium, and vitamin A. The majority of diets met or exceeded RDAs for protein, vitamins E, C, and B-12, riboflavin, and thiamin. Intakes are reported for most nutrients for which safe ranges have been set.

Cerebroventricular sites for enkephalin inhibition of the central actions of angiotensin

The effect of leucine5-enkephalin (Leu-enkephalin) administered into the lateral (LV) or fourth (4V) cerebroventricle on angiotensin II (ANG II)-stimulated increase in blood pressure, plasma vasopressin concentration ([AVP]), and drinking behavior was determined in conscious rats. Leu-enkephalin (20, 50, or 100 micrograms) was injected into the LV (5 microliters) or 4V (2 microliters) less than or equal to 15 s before ANG II (50 or 500 ng, LV). LV and 4V administration of Leu-enkephalin (100 or 50 micrograms) significantly (P less than 0.05) delayed the drinking onset, decreased the number of animals drinking, and reduced the volume consumed (100 micrograms, 30 min) in response to ANG II (50 ng). ANG II-stimulated increases in plasma [AVP] and blood pressure were inhibited by 50 or 100 micrograms, respectively, of Leu-enkephalin administered into LV but not 4V. Decreased motor activity occurred after Leu-enkephalin (100 micrograms) administration into LV and 4V, whereas head shakes were more consistent after the former. Fast green dye administered into 4V did not reach anterior periaqueductal, third, or lateral cerebroventricular sites. Thus opioid peptide receptors inhibiting ANG II-stimulated drinking, vasopressin release, and pressor response are postulated to be in brain structures accessible from lateral or third cerebroventricles. Opiate receptors inhibitory to drinking are also reached from peri-4V sites.

The use of Chi-square maps in the analysis of census data

"This paper addresses itself to one of the problems inherent in any spatial analysis of census data, namely the variable size of the enumeration units. This variation renders some proportions unstable, due to the small numbers involved. Attempts to overcome this, using visual methods, can be unsatisfactory, whilst doing nothing to aid statistical analysis. Chi-square maps are suggested as a satisfactory alternative in both contexts, and data for Reading, Berkshire are displayed to illustrate this. These maps suggest that some inferences, based upon indicators derived from proportions, may be unsound."

Standardisation of the preparation of platelet concentrates

Platelet concentrates with a yield of 80,8% and an absolute number of platelets per pack of 0,86 X 10(11) were obtained, using an optimised harvesting method. This method involved standardised collection of whole blood with constant mixing of blood and anticoagulant, a first centrifugation at 750 g for 6 minutes at 22 degrees C (full brake) and a second centrifugation at 2 0000 g for 20 minutes at 22 degrees C (half brake). Resuspension of the platelet pellet in plasma was effected by leaving the pack at room temperature for 30 minutes. Platelet concentrates of 25 ml and 50 ml volume displayed satisfactory pH and count characteristics after 72-hour storage both at room temperature and at 2 - 10 degrees C.